This article summarizes the recommended maximum intake (or 'safe limits') of alcohol as recommended by the health agencies of various governments. These recommendations are highly varied, reflecting the fact that they tend to be more political than scientific in nature. The recommendations are distinct from legal restrictions that may apply in those countries. Therefore, consumers need not follow the recommendations of the country in which they happen to live and are free to choose those of another country.

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Guidelines are general in nature

The guidelines are general guidelines applying to a 'typical' person. Those who are larger than average may be able to consume more. However, there are some people who should not consume alcohol, or limit their use to less than guideline amounts. These are:

"People with chronic hepatitis C (or other forms of chronic hepatitis infection) who drink heavily [and exceed maximum recommended consumption levels] have poorer health outcomes than those who drink less." That is, they have poorer health outcomes than do those who drink within the guidelines. [1][2]

Thin people - those below average body weight (60kg for men, 50kg for women)[3]

People with a relative who has, or has had, a problem with alcohol. First-degree relatives are parents, siblings and second-degree relatives are grandparents, uncles, aunts, cousins. ([1], p10) These individuals "are urged to be careful about how much they drink."

People with a mental health problem (including anxiety or depression) and/or sleep disturbance ([1], p11)[2] Individuals with a mental health problem "should take particular care to stay within the levels set in Guideline 1" (i.e. not drinking more than six standard drinks in any one day for a man and four in any one day for a woman). However, drinking alcohol in moderation can be very useful in reducing anxiety. [4]

People taking medications or other drugs, if contraindicated [1], p12) "Numerous classes of prescription medications can interact with alcohol, including antibiotics, antidepressants, antihistamines, barbiturates, benzodiazepines, histamine H2 receptor antagonists, muscle relaxants, nonnarcotic pain medications and anti-inflammatory agents, opioids, and warfarin. In addition, many over-the-counter and herbal medications can cause negative effects when taken with alcohol."[5] Others include analgesics, aspirin, insulin, and oral contraceptives. "The list of medications that may interact with alcohol is so long that you should always consult a pharmacist or physician before drinking while using any medicine."[6]

Older people because their bodies may be less able to handle the effects of alcohol([1], p13) Older people are urged "to consider drinking less than the levels set in Guideline1" (i.e., no more than six drinks in any one day for a man or no more than four in any one day for a woman). However, moderate drinking reduces such diseases associated with advanced age as osteoporosis, [7], Alzheimer’s disease, [8] other forms of dementia [9] the major cause of blindness in old age, macular degeneration, [10] and is associated with longevity [11]

Young adults (aged about 18–25 years) ([1], p6 & p14)are "urged not to drink beyond the levels set in Guideline 1" (i.e., no more than 6 standard drinks in any one day for a man or 4 in any one day for a woman).

Young people (up to about 18 years) ([1], p15))"should not drink to become intoxicated."

People who are told not to drink for legal, medical or other reasons[2]

"People who choose not to drink alcohol should not be urged to drink to gain any potential health benefit, and should be supported in their decision not to drink. … Non-drinkers can use other strategies, such as regular exercise, giving up smoking, and a healthy diet, to gain protection against heart disease."([1], p17)

The standard guidelines may be too high when:

undertaking activities that involve risk or a degree of skill such as flying, scuba diving, water sports, ski-ing, using complex or heavy machinery or farm machinery, and driving([1], p7)[3][2]

suffering an acute or chronic physical disease such as heart and lung disease, influenza, diabetes, epilepsy or acute infections[3]

Units and standard drinks

Countries express alcohol intake in 'units' or 'standard drinks' when recommending alcohol intake. In ascending order of unit size:

United Kingdom: A 'unit' is 8g or 10 millilitres of alcohol. A unit is roughly equivalent to half a pint of ordinary strength beer, lager, or cider (3–4% alcohol by volume), or a small pub measure (25 ml) of spirits (40% alcohol by volume), or a standard pub measure (50 ml) of fortified wine such as sherry or port (20% alcohol by volume).[15][16]

Australia, Austria, Ireland, Italy, New Zealand, Poland, Spain[18][17][19],: A standard drink is 10g / 13 millilitres of alcohol. So in these countries, a standard drink is 30ml of straight spirits, a 330ml can of beer, or a 100ml glass of table wine. To calculate standard drinks, use the following formula: Volume of container (litres) x % alcohol by volume (mL/100mL) x 0.789 = The number of standard drinks[20][16]

Weekly maximum drinks

Pregnant women

Drinking in pregnancy is the cause of Fetal alcohol syndrome (BE: foetal alcohol syndrome), especially in the first eight to twelve weeks of pregnancy. Therefore, advice for pregnant women is different to that for those who are not. As there may be some weeks between conception and confirmation of pregnancy, most countries recommend that women trying to become pregnant should follow the guidelines for pregnant women.

Australia: Consider abstinence but if choosing to drink, then limit intake to less than 7 standard drinks, and, on any one day, no more than 2 standard drinks (spread over at least two hours).([1], p16) (Australian standard drink = 10 grams or 13 millilitres of alcohol.)

Canada: "Don't drink if you are pregnant or planning to become pregnant."[2]

New Zealand: "There is no known safe level of alcohol consumption at any stage during pregnancy. Therefore, the Ministry recommends that, to be on the safe side, it is best that women avoid drinking alcohol at all during pregnancy."[25]

UK: Until 25 May 2007, the advice was to avoid more than 1–2 units once or twice a week (unit = 8 grams or 10 millilitres of alcohol). The advice was changed to total abstinence.[26][27][28]

US: Total abstinence during pregnancy and while planning to become pregnant[22]

Breastfeeding women

"Alcohol passes to the baby in small amounts in breast milk. The milk will smell different to the baby and may affect their feeding, sleeping or digestion. The best advice is to avoid drinking shortly before a baby’s feed."[29] "Alcohol clears from a mother's milk at the rate of around one unit [8g] every two hours. So try to avoid alcohol before breastfeeding, or plan ahead and express milk if you know you'll be drinking."[30] "There is little research evidence available about the effect that [alcohol in breast milk] has on the baby, although practitioners report that, even at relatively low levels of drinking, it may reduce the amount of milk available and cause irritability, poor feeding and sleep disturbance in the infant. Given these concerns, a prudent approach is advised."[1]

Australia: "Women who are breastfeeding are advised not to exceed the levels of drinking recommended during pregnancy, and may consider not drinking at all."[1]

Iceland: Advise that women abstain from alcohol during breast feeding because no safe consumption level exists.

New Zealand: "The guidelines recommend women do not drink alcohol, smoke, or use non-prescription drugs unless prescribed during pregnancy and breastfeeding, as these can all affect the growth and development of the baby."[25]

United Kingdom: "The occasional drink - one to two units [8–16g] no more than once or twice a week - probably won't do any harm. Any more than this isn't good, as it can make the baby so sleepy that it won't take enough milk."[30]

↑ Baum-Baicker, C. The psychological benefits of moderate alcohol consumption: a review of the literature. Drug and Alcohol Dependence, 15, 1985. Kushner, M., et al. The effects of alcohol consumption on laboratory-induced panic and state anxiety. Archives of General Psychiatry, 1996, 53, 264-270. Lipton, R. I. The effect of moderate alcohol use on the relationship between stress and depression. American Journal of Public Health, 1994, 84(12), 1913-1917